Laboratory of Experimental Surgery and Surgical Research N.S. Christeas, Athens University Medical School, National and Kapodistrian University of Athens, Athens, Greece.
J Clin Hypertens (Greenwich). 2020 Jul;22(7):1134-1144. doi: 10.1111/jch.13940. Epub 2020 Jul 9.
The present meta-analysis aims to compare renal arterial and venous Doppler parameters in women with preeclampsia and healthy pregnant controls. Medline, Scopus, Cochrane Central Register of Controlled Trials, Clinicaltrials.gov, and Google Scholar databases were systematically searched from inception to December 04, 2019. All observational studies reporting renal resistive index, pulsatility index, renal interlobar vein impedance, or pulse transit time among preeclamptic and healthy pregnant women were held eligible. Subgroup analysis was conducted on the basis of disease onset and side of measurement. Both pair-wise and network meta-analysis were performed using Review Manager 5.3 and R-3.4.3 software. Fourteen studies were included, with a total of 1118 women. No difference of renal resistive (MD: 0.00, 95% CI: [-0.03, 0.04]) and pulsatility index (MD: -0.01, 95% CI: [-0.14, 0.12]) was evident between the two groups. Renal interlobar vein impedance was estimated to be significantly higher in preeclampsia (MD: 0.07, 95% CI: [0.06, 0.09]), while venous pulse transit time was significantly lower (MD: -0.10, 95% CI: [-0.14, -0.05]) in women with the disease. Subgroup analysis indicated that early-onset preeclampsia was associated with significantly elevated renal interlobar vein impedance and lower venous pulse transit time than late-onset disease. The outcomes of the present meta-analysis suggest that preeclampsia is characterized by venous hemodynamic dysfunction as it is associated with significantly elevated renal interlobar vein impedance and shorter venous pulse transit time. Future large-scale prospective studies should introduce cutoff values and determine the optimal timing of measurement in order to achieve optimal predictive accuracy.
本荟萃分析旨在比较先兆子痫妇女和健康孕妇的肾动脉和静脉多普勒参数。系统检索了 Medline、Scopus、Cochrane 对照试验中心注册库、Clinicaltrials.gov 和 Google Scholar 数据库，检索时间从建库至 2019 年 12 月 04 日。所有报告肾阻力指数、搏动指数、肾叶间静脉阻抗或脉冲通过时间的观察性研究均符合入选标准。根据疾病的发病和测量部位进行了亚组分析。使用 Review Manager 5.3 和 R-3.4.3 软件进行了两两比较和网络荟萃分析。纳入了 14 项研究，共 1118 名女性。两组间肾阻力（MD：0.00，95%CI：[-0.03，0.04]）和搏动指数（MD：-0.01，95%CI：[-0.14，0.12]）无差异。肾叶间静脉阻抗在先兆子痫中估计明显较高（MD：0.07，95%CI：[0.06，0.09]），而静脉脉冲通过时间在疾病患者中明显较低（MD：-0.10，95%CI：[-0.14，-0.05]）。亚组分析表明，早发型子痫前期与肾叶间静脉阻抗明显升高和静脉脉冲通过时间明显缩短有关。本荟萃分析的结果表明，子痫前期的特征是静脉血液动力学功能障碍，因为它与肾叶间静脉阻抗明显升高和静脉脉冲通过时间缩短有关。未来的大规模前瞻性研究应引入临界值，并确定最佳的测量时间，以实现最佳的预测准确性。
